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Examines Link Between Physicians and the Drug Industry
Michael A. Piekarz
editorial in the Journal of the American Medical Association (JAMA)
has prompted swift senatorial action that may soon require physicians
to publicly disclose financial ties they may have to drug companies.
The JAMA editorial acknowledged that physicians have allowed the practice of
accepting fees and gifts from drug companies to become commonplace and that they
have allowed this practice to influence their medical decisions to varying degrees.
The JAMA editors called for physicians to reject payments and gifts in any form
from the pharmaceutical and medical device industries.
An earlier study has shown a significant financial link between the pharmaceutical
industry and practicing physicians. Ninety-four percent of doctors reported that
they have at least one type of relationship with the drug industry, mostly in
the form of receiving food in the workplace or prescription samples.
More than one-third of physicians are reimbursed for costs associated with professional
meetings or continuing medical education, and more than a quarter receive honoraria
for consulting, lecturing or enrolling patients in clinical trials, said researchers
at Massachusetts General Hospital-Partners Health Care System, Yale University
and the University of Melbourne and Royal Melbourne Hospital in Australia.
Institute for Health policy director David Blumenthal, M.D., one of the co-authors
of the report, suggested that companies target opinion leaders for marketing
by making industry payments to physicians who have developed clinical guidelines
and who serve as mentors for doctors in training.
“I know it’s cliché, but if it didn’t work, drug companies
wouldn’t do it,” said Blumenthal. “It appears pretty clear
that industry forms tighter relationships with doctors who are really the thought
leaders, the ones who are likely to affect the behavior of other doctors.”
JAMA’s mandate that physicians should be required to disclose their financial
ties with the pharmaceutical industry led to swift Senate action calling for
a federally-legislated financial disclosure law also known as a “Sunshine
“Transparency will help make the pharmaceutical and medical device industry
more accountable to the public, and that’s good for public safety and public
confidence,” said Senator Chuck Grassley, R-Iowa, ranking member of the
Committee on Finance. “Our bipartisan Physician Payments Sunshine Act is
an important reform that Congress needs to consider sooner rather than later.”
“It appears that the editors at JAMA share our fear —that the lack
of transparency is undermining the public’s confidence in the integrity
of their physicians. I hope the article serves as a wake-up call to both the
medical and drug industries,” said Senator Herb Kohl, D-Wis., chairman
of the Special Committee on Aging.
“It’s time to seek meaningful change in the form of the Physician
Payments Sunshine Act.”
Last June, The Aging Committee held a hearing examining the relationships between
physicians and the pharmaceutical industry. Following the hearing, Senators Grassley
and Kohl introduced the Physician Payment Sunshine Act (S.2029) to require manufacturers
of pharmaceutical drugs, medical devices and biologics to disclose the amount
of money they give to doctors through payments, gifts, honoraria, travel and
In February of this year, The Aging Committee held a second hearing to specifically
examine the financial interactions between medical device companies and surgeons.
Also underscored was the need for physician access to unbiased research about
drugs available on the market. In March, Kohl held a third hearing on a practice
known as academic detailing as an alternative to the prevailing practice of doctors
receiving the latest information on new drugs from the drug manufacturers themselves.
At the hearing, Kohl announced his plan to introduce a bill to create a federal
academic detailing program. The bill would address a claim made by the drug industry
that the Physician Payment Sunshine Act would potentially restrict their ability
to inform doctors about new drugs.
Further Senate action is expected.
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